Despite substantial efforts to reduce its incidence, traumatic head injury continues to be a major problem in pediatrics. Both minor and major head injuries result in significant morbidity and mortality. Considerable controversy surrounds the appropriate evaluation of children with mild alterations in consciousness after closed head trauma Glasgow Coma Scale (GCS) score of 13-14.

Associated injuries are also common findings in head injury victims. Thus importance of primary and secondary survey cannot be overemphasized. Primary survey encompasses detection of life-threatening injuries and is immediately followed by resuscitative measures.

Conversely, many authors have suggested that abnormalities on neurological examination and clinical symptoms are not reliably present in children with TBI. Computed tomography (CT) scans of the head can identify TBI with high sensitivity, yet universal imaging of all children with minor head trauma would result in unnecessary tests with high costs and waste time and resources. Thus, the goal of management of minor head trauma in children is to identify and treat intracranial injury (101) while limiting unnecessary diagnostic procedures.

Keywords: head trauma, traumatic brain injury, skull fracture